| NPI | 1073246203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: NC 0010-12258) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: NC 0010-12258) |
| 363A00000X Physician Assistant (Licence: NC 0010-12258) | |
| Enumeration Date | 2022-07-06 |
| Last Update Date | 2024-06-17 |